Interim Rate Reviews

Interim reports are an important tool to determine the accuracy of Medicare and Medicaid payments. Additionally, interim reports can ensure that adequate financial reserves are maintained during the year. This helps avoid material changes to end-of-year financial statements because of over or underpayments received during the year.

Critical access hospitals with significant changes in inpatient census or outpatient volumes can use interim reports to ensure adequate reimbursement rates or if lump-sum adjustments are necessary. Typically CMS requires a minimum of two rate reviews annually for critical access hospitals. Unless updated information is used in the rate reviews, these hospitals can be subject to payment rates that can be significantly different than those determined when the cost report is filed.